Skip to Content

Provider Manual

Workers' Compensation

Last Updated on January 24, 2019
  • Security Health Plan does not cover the cost of services covered by Workers’ Compensation. Claims that are determined to be work-related will be denied using ANSI code 19. The denial reason will print on the affiliated provider’s reimbursement statement. Claims must be submitted to Workers’ Compensation first. 
  • If claims have already been paid by Security Health Plan, related charges will be reversed. The adjustment will be reflected on the affiliated provider’s reimbursement statement, using ANSI 19. 
  • If the affiliated provider is overpaid due to payment from Workers’ Compensation, the affiliated provider should complete an adjustment request form and send it along with a copy of the original claim and a copy of the EOB from Workers’ Compensation. Security Health Plan will reverse charges. The adjustment will be reflected on the affiliated provider’s reimbursement statement. 
  • If Workers’ Compensation denies a claim, Security Health Plan will consider payment if a copy of the denial is attached. Security Health Plan will then pursue directly with Workers’ Compensation or an attorney if one has been retained. The affiliated provider must submit within 180 days from the date on the denial. 
  • If the affiliated provider has any questions regarding Workers’ Compensation, please call 715-221-9443 or 1-888-213-4883, Monday through Friday between 8 a.m. and 4:30 p.m.